BC Cancer, Department of Pathology, Vancouver, BC V5Z 4E6, Canada.
Division of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, Toronto, ON M5G 2C4, Canada.
Curr Oncol. 2022 Jul 15;29(7):4981-4997. doi: 10.3390/curroncol29070396.
Non-small cell lung cancer (NSCLC) has historically been associated with a poor prognosis and low 5-year survival, but the use of targeted therapies in NSCLC has improved patient outcomes over the past 10 years. The pace of development of new targeted therapies is accelerating, with the associated need for molecular testing of new targetable alterations. As the complexity of biomarker testing in NSCLC increases, there is a need for guidance on how to manage the fluid standard-of-care in NSCLC, identify pragmatic molecular testing requirements, and optimize result reporting. An expert multidisciplinary working group with representation from medical oncology, pathology, and clinical genetics convened via virtual meetings to create consensus recommendations for testing of new targetable alterations in NSCLC. The importance of accurate and timely testing of all targetable alterations to optimize disease management using targeted therapies was emphasized by the working group. Therefore, the panel of experts recommends that all targetable alterations be tested reflexively at NSCLC diagnosis as part of a comprehensive panel, using methods that can detect all relevant targetable alterations. In addition, comprehensive biomarker testing should be performed at the request of the treating clinician upon development of resistance to targeted therapy. The expert multidisciplinary working group also made recommendations for reporting to improve clarity and ease of interpretation of results by treating clinicians and to accommodate the rapid evolution in clinical actionability of these alterations. Molecular testing of all targetable alterations in NSCLC is the key for treatment decision-making and access to new therapies. These consensus recommendations are intended as a guide to further optimize molecular testing of new targetable alterations.
非小细胞肺癌（NSCLC）的预后和 5 年生存率历来较差，但在过去 10 年中，靶向治疗在 NSCLC 中的应用改善了患者的预后。新的靶向治疗方法的发展速度正在加快，这需要对新的可靶向改变进行分子检测。随着 NSCLC 中生物标志物检测的复杂性增加，需要指导如何管理 NSCLC 中的动态标准护理，确定务实的分子检测要求，并优化结果报告。一个由肿瘤内科、病理学和临床遗传学代表组成的多学科专家工作组通过虚拟会议聚集在一起，为 NSCLC 中新的可靶向改变的检测制定了共识建议。工作组强调了准确和及时检测所有可靶向改变的重要性，以便使用靶向治疗优化疾病管理。因此，专家组建议在 NSCLC 诊断时作为综合检测的一部分，使用能够检测所有相关可靶向改变的方法，对所有可靶向改变进行反射性检测。此外，应根据治疗临床医生的要求，在出现靶向治疗耐药时进行全面的生物标志物检测。该多学科专家工作组还提出了报告建议，以提高治疗临床医生对结果的解读清晰度和易读性，并适应这些改变在临床可操作性方面的快速演变。对所有可靶向改变进行 NSCLC 的分子检测是治疗决策和获得新疗法的关键。这些共识建议旨在进一步优化新的可靶向改变的分子检测。
